Exposure to per- and polyfluoroalkyl substances (PFASs) in serum versus semen and their association with male reproductive hormones

Given that per- and polyfluoroalkyl substances (PFASs) exhibit different distribution in the serum and semen of adult men, improving our understanding of the predictors of PFAS concentrations in paired serum and semen samples from an individual is essential. Here, we investigated and compared the effects of emerging and legacy PFAS concentrations in serum and semen on reproductive hormone levels in serum within a Chinese adult male population. We explored the relationships among perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorooctane sulfonate (PFOS), and chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA) in serum and semen with reproductive hormones in serum among 651 adult men from Nanjing, China. Significant relationships among all analyzed serum and semen PFASs and decreased total testosterone (total T) were found. Serum and semen PFOA levels were associated with significant decreases in free T. Furthermore, the levels of sex hormone-binding globulin (SHBG) were significantly decreased in association with PFNA, PFOS, and 6:2 Cl-PFESA exposure. Negative relationships between the total T/luteinizing hormone (LH) ratio and semen concentrations of selected PFASs were also observed. After adjustment of PFAS concentrations (in both semen and serum), stronger associations of PFASs with total T, free T, estradiol (E2), SHBG, and total T/LH were observed in semen than in serum. We found that 84.8% of the associations between serum PFOA with total T were mediated by semen PFOA. Thus, elevated PFAS exposure may have negative effects on male reproductive health, and semen PFAS may be a better exposure indicator for the male reproductive system than serum PFAS.